Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Domingo, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1689316499

Justin Domingo, MD is a Student in an Organized Health Care Education/Training Program in Wynnewood, Pennsylvania. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone: (484) 476-1619
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1689316499
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 12, 2022
Last updated in NPPESApril 12, 2022
Certification dateApril 12, 2022
Mailing address1257 Judy Rd, Mohegan Lake, NY 10547-1904

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